PedSPAM May 2003
Welcome to the PedSPAM archive for May. Here are the month's daily SPAMlets from my update reading that you might have missed:
In the News
Monday, May 5: Doctors of the Netherlands Kidney Association are trying to improve the diagnosis and treatment of urinary tract infections in young children in their country, to reduce the number of children who develop kidney damage from infections. They want to raise awareness among Dutch physicians about kidney infections in children under four, to prevent infections and the major long-term consequence of repeated infections, which is kidney dialysis and transplant. Reuters Health
Tuesday, May 6: An acellular pertussis combination vaccine used in Great Britain against Hemophilus influenzae type B (HiB) meningitis infection during a vaccine shortage led to a dramatic seven-fold increase in HiB meningitis cases. The substitute vaccine was found in retrospect not to provide the same level of immunity to HiB infection as the one previously used. The difference was a change from whole-cell pertussis component to an acellular pertussis component. Somehow this change decreased the immunogenicity of the HiB vaccine component of the combination product. Lancet 2003;361:1521-1523.
Wednesday, May 7: Infant formulas made with palm oil to simulate the fatty acid composition of breast milk may inadvertently depress bone mineralization. In a study comparing formula with and without palm oil tested in a group of randomly selected babies, babies fed the palm-oil containing formula showed significantly lower bone mineral content and bone mineral density at 3 and 6 months. Enfamil® contains palm oil; Similac® does not. Pediatrics 2003;111:1017-1023.
Thursday, May 8: Pertussis (whooping cough) is a disease that is most dangerous - potentially fatal - for the very youngest infants. Complete immunity is not achieved until the third vaccination is given, usually around 2 months of age. Italian researchers have studied giving the acellular pertussis vaccine at birth, and found that this procedure significantly increases immunity at the earliest ages. Pediatrics 2003;111:1042-1045.
Tuesday, May 13: If parents quit smoking before their child reaches third grade, the child is 39% less likely to have their child start smoking as a teenager than a child whose parents continue to smoke. Third grade is unfortunately the age when many children begin to experiment with smoking. By quitting before that time, parents not only protect their child from the effects of second hand smoke, but reduce the risk of him becoming a smoker. Addiction 2003;98:585-593.
Wednesday, May 14 Irrigating wounds with plain tap water works just as well as washing with sterile saline solution in the emergency room setting, this study found. Children with simple lacerations received flushing of their wound with either sterile saline in an irrigation syringe, or by simply holding the laceration under flowing tap water (using an extension tube if necessary). Healing and infection rates were identical in the two groups. Annals of Emergency Medicine 2003;41:609-616.
Demonstrating what moms have known forever - flush that cut with lots of water!
Thursday, May 15: Three babies are "doing very well" after receiving pioneering liver cell transplants in the United Kingdom. The procedure involves injecting donor liver cells into the liver of the recipient during a surgical operation. The donor cells take root and multiply. These new cells correct genetic defects in the liver cells of the recipient. In this case, one infant had a blood clotting disorder (Factor VII deficiency), one had a fatal hereditary progressive liver disease, and one had a defect of waste product metabolism. The procedure holds the promise of reducing the need for liver transplantation to a significant degree. Reuters Health
Friday, May 16: About one in seven of American teens borrow or share prescription medications at some time with friends and family. This finding by the US Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia raises troubling issues, especially for the potent acne medication isotretinoin (Accutane®). Accutane causes birth defects, and female patients are required to use two forms of birth control as well as get a pregnancy test for each medication refill. Pediatrics 2003;111:1167-1170.
Adolescents and their parents need to heed this warning - do not share medications with friends or family.
Monday, May 19: Antidepressant medications for nursing mothers do not adversely affect infant weight gain in their babies. In fact, these medications are protective against poor weight gain in babies of depressed mothers. Journal of Clinical Psychiatry 2003;64.
Tuesday, May 20: Night lights do not cause myopia (nearsightedness), another British study found. The original report in 1999 (see PedSPAM) claimed that night light exposure in infancy increased the risk of nearsightedness. There have since been several studies contradicting that idea; this is the latest one. A sample of 122 university students were tested for nearsightedness, and their parents questioned about their sleep habits as young infants and toddlers under two years of age. No relation was found to night light use, but there was a strong genetic component to nearsightedness. British Journal of Ophthalmology 2003; 87:580-582.
Wednesday, May 21: Amblyopia or "lazy eye," is a condition of young children in which there is progressive loss of vision in the weaker of the eyes. It is often treated by patching the eye with better vision to force the brain to use the weaker eye. This improves the function of the weaker eye and can improve vision significantly and in so doing, halt and reverse the process of visual deterioration. Keeping the patch on young children all day is recommended, but often difficult. This new study finds that 2 hours a day of patching works about as well as 6 - which should be good news for children and parents who must do this therapy. Archives of Ophthalmology 2003;121:603-611.
Friday, May 23: California authorities say that the state's rate of autism has nearly doubled in the last 4 years. A study of children referred to the California Department of Developmental Services documented a 97% rise in the number of cases of autism receiving services. A study conducted at the UCLA Neuropsychiatric Institute refuted the idea that the dramatic increases in autism in California were not due to changes in population or better reporting of new cases.
Tuesday, May 27: Hemangiomas are benign blood vessel tumors that may or may not be visible at birth. While many hemangiomas resolve spontaneously by the time a child is 10 years of age, some types undergo rapid enlargement for the first months of life, and are potentially disfiguring if they occur on the face. This study found that parents of children with hemangiomas undergo major emotional stress, more so than their children. Parents in this survey study reported feeling fear and anxiety about their child's birthmark, and most reported receiving negative stares or comments about their child's birthmark. Archives of Facial Plastic Surgery 2003;5:229-234.
Wednesday, May 28: A recent study by two American researchers linking the MMR (measles-mumps-rubella) immunization to increased risk of autism was condemned as "seriously flawed" by Britain's Medicines and Healthcare Products Regulatory Agency. The chairman of the Agency, said in a statement: "In no way are the conclusions of the authors of this study justified." The authors used data from the US Vaccine Adverse Event Reporting System (VAERS) to examine new diagnoses of autism following DTP (diphtheria-pertussis-tetanus)immunizations as compared to MMR shots. The rate of autism diagnosed following the MMR was about five times higher that for children following a DTP shot. The spokesman for the Medicines and Healthcare Agency pointed out that in the U.S., DTP vaccine is given at 2, 4, 6 and 15-18 months and MMR is first given at 12-15 months. Most diagnoses of autism are not made until after 15 months, with the average closer to 2 years of age. "It is essential that children of similar age are compared. Age imbalances in the groups would be sufficient to make the study results invalid." International Paediatrics 2003;18:108-113.
I agree. The study in question did not compare apples to apples. Most DTP shots are given to children much too young to be diagnosed with autism, even if it is already present (as is believed). Other well controlled studies have found no causal link to any immunization.
Friday, May 30: A Belgian researcher has determined that regular use of indoor swimming pools is a risk factor for asthma. Apparently, exposure to the chemical byproducts of pool chlorination causes significant lung irritation in swimmers or even those who sit near an indoor pool for as little as an hour. This chemical effect is associated with an increased risk of asthma. Occupational and Environmental Medicine 2003;60:385-394.